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Publication Detail
Is there an incremental rise in the risk of obstetric intervention with increasing maternal age?
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Rosenthal AN, Paterson-Brown S
  • Publication date:
  • Pagination:
    1064, 1069
  • Journal:
    British Journal of Obstetrics and Gynaecology
  • Volume:
  • Issue:
  • Print ISSN:
  • Keywords:
    analysis, data, Gestational Age, Incidence, London, Newborn, NULLIPAROUS WOMEN, OLDER, POPULATION, Pregnancy, RATES, RISK, WOMEN
  • Addresses:
    Queen Charlottes & Chelsea Hosp, London W6 0XG, England
  • Notes:
    WoS ID: 000076638500005 Times Cited: 25 Article English Rosenthal, A. N St Bartholomews Hosp, Gynaecol Canc Res Unit, London EC1A 7BE, England Cited References Count: 15 132PJ P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND OXFORD
Objective To determine whether increasing maternal age increases the risk of operative delivery and to investigate whether such a trend is due to fetal or maternal factors. Design Analysis of prospectively collected data on a maternity unit database. Setting A postgraduate teaching hospital. Population 6410 nulliparous women with singleton cephalic pregnancies delivering at term (37-42 weeks of gestation) between 1 January 92 and 31 December 95. Main outcome measures Mode of delivery, rates of prelabour caesarean section, induction of labour and epidural usage. Results There was a positive, highly significant association between increasing maternal age and obstetric intervention. Prelabour (P < 0.001) and emergency (P < 0.001) caesarean section, instrumental vaginal delivery (spontaneous labour P < 0.001; induced labour P = 0.001), induction of labour (P < 0.001) and epidural usage in spontaneous labour (P = 0.005) all increased with increasing age. In the second stage of labour fetal distress and failure to advance, requiring instrumental delivery, were both more likely with increasing maternal age (in both P < 0.001). Epidural usage in induced labour and the incidence of small for gestational age newborns did not increase with increasing maternal age (P = 0.68 and P = 0.50, respectively). Conclusions This study demonstrates that increasing maternal age is associated with an incremental increase in obstetric intervention. Previous studies have demonstrated a significant effect in women older than 35 years of age, but these data show changes on a continuum from teenage years. This finding may reflect a progressive, age-related deterioration in myometrial function
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